You grew up in a family of substance users. You know that your risk for developing an addiction to drugs or alcohol is greater because of this hereditary factor. But what exactly are your risks? And is there anything you can do to reduce your risk?
According to the National Council on Alcoholism and Drug Dependence (NCADD), the single most reliable indicator for risk of future alcohol or drug dependence is family history. In an article written for NCADD, Robert Morse, MD, former Director of Addictive Disorders Services at the Mayo Clinic and member of NCADD’s Medical/Scientific Committee, says, “Research has shown conclusively that family history of alcoholism or drug addiction is in part genetic and not just the result of the family environment…millions of Americans are living proof. Plain and simple, alcoholism and drug dependence run in families.”
How Family History Affects your Chances for Addiction
Family history affects your chances of addiction in many ways. Genes are one important factor. But alcoholism and drug addiction are “genetically complex.”
Recent research has identified numerous genes, and variations within these genes, that are associated with the addictive process. One way genes affect a person’s risk for addiction involves how genes metabolize alcohol. Another is how nerve cells signal one another and regulate their activity. Such changes in genes can be passed down from one generation to another.
Perhaps the strongest evidence for heredity’s role in addiction comes from twin studies and adoption studies. Studies of twins found a 60% rate of similarity regarding addiction in identical twins vs. a 39% rate of similarity in fraternal twins. Studies of children adopted in infancy and studied for addiction risk in adulthood found that biological sons of alcoholics were four times more likely to become alcoholics, even when the adoptive parent had no issues with addiction, so the l factor of family environment was minimal.
But genetic predispositions are not the only factor in predicting the role of family history in addiction risk. Environmental aspects also play a role, even though they may be less significant in some cases.
Researchers have identified several family-related risks for increased vulnerability:
- Family dysfunction (conflicts or aggression)
- A parent who is depressed or has other psychological issues
- One or more parents who abuses or is addicted to drugs or alcohol
Additional social and personal issues that contribute to risk include:
- Limited social skills
- Fragile self-esteem
- Minimal or no support system
- Personal history of impulsivity, aggression or difficulty managing emotions
- A history of trauma or abuse (high risk for post traumatic stress)
- Other psychiatric disorders such as depression, anxiety or bi-polar disorder
- Friends or acquaintances who are regular users and who provide easy access to drugs or alcohol
Addressing and Reducing Risks
An alternative viewpoint regarding a family history link for addiction comes from a National Institute of Health (NIH) meta-study of 65 published papers documenting 766 study participants who were college or university students. Controlling for alcohol consumption and use disorders, family history was reviewed as the variable. The meta-study found that students who had family histories of alcohol or drug problems did not drink more but they were likely to be more at risk for problems that are associated with drug or alcohol use (ex: causing shame or embarrassment to someone; passing out or fainting; or having problems with school).
The bottom line is that there are still a lot of uncertainties when it comes to assessing drug and alcohol risks as they relate to family history. The good news is that even if you come from a family with a troubled history, or a history of addictions, that does not mean you will automatically become an addict. The risk is higher, but there are ways to prevent that from happening. You can choose to be proactive and greatly reduce your addiction risk.
Here are a few suggestions to reduce your addiction risk:
- Avoid under-age drinking or substance use; early-onset of use increases risk
- Choose abstinence or carefully monitor your consumption
- Avoid associating with heavy drinkers or substance users
- Manage your psychological health; seek assistance from a mental health provider if you are highly stressed, anxious or depressed
- Participate in workplace or school prevention programs
Should you already find yourself dealing with an alcohol or drug issue, here are some intervention strategies provided by the National Institute of Health, in their publication, Alcohol Alert:
- Motivational Interview: This strategy focuses on enhancing your motivation and commitment to changing your behavior, if you are currently abusing drugs or alcohol. Typically you would work with an addictions counselor or mental health professional and discuss your beliefs, choices and behaviors associated with substance use. The purpose of the interview is to help you develop a realistic view of your use, problems associated with it and your treatment goals and expectations.
- Cognitive–Behavioral Interventions: These strategies are taught by a counselor or therapist, or they can sometimes can be accessed via an online self-help program. They help you change your behavior by helping you recognize when and why you drink excessively or use illegal substances. Cognitive-behavioral approaches challenge irrational expectations about substance use and raise your awareness of how drugs or alcohol affect your health and well-being. They provide tools for mentally and emotionally addressing denial, resistance, self-criticism and shame.
- Drug-Free Workplace programs: Many workplaces now help their employees who are abusing alcohol or drugs. Lifestyle campaigns encourage workers to ease stress, improve nutrition and exercise, and reduce risky behaviors such as drinking, smoking, or drug use. Other programs promote social support and volunteerism. Many Employee Assistance Programs offer employees referrals to substance abuse or other treatment programs, and may help pay for treatment.
Remember, the risk for alcohol and drug addiction does run in families. But you can manage the risk and avoid an addiction problem in your own life. Be proactive in monitoring your substance use, manage your mental and emotional health and seek support if you need it. The final outcome will depend on you and the choices you make today, not on your history.
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